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PHI Calls on Trump Administration to Invest in Direct Care Workforce

March 17, 2017

On March 21, at the national Aging in America conference, PHI released its 2017 federal priorities, calling on the Trump administration and Congress to strengthen the direct care workforce—nearly 5 million home care workers and nursing assistants—by protecting Medicaid, improving training and wages, and enacting reforms that would promote recruitment and retention in a workforce facing a severe shortage.

“Paid caregivers are key to economic development in our communities, but we must improve these jobs to ensure they offer stable employment for jobseekers and reliable care for clients,” said Jodi M. Sturgeon, president of PHI. “A federal investment in this workforce will go a long way to lift up families on both sides of the care divide.”

Policy Priorities
The new report—Federal Policy Priorities: Strengthening the Direct Care Workforce—recommends policy changes across five areas: wages and benefits, training and advanced roles, data collection and quality, expanding access and cultural competence, and family caregivers. Highlights include:

  • Protect expanded Medicaid benefits to allow direct care workers to obtain health coverage and expand access to long-term services and support among low-income Americans
  • Improve training standards, competency requirements, and programmatic interventions so that older people and people with disabilities can receive the skilled support they need and prefer; and
  • Collect ongoing, reliable data on this workforce to effectively monitor this workforce, inform public policy and workforce initiatives, and promote the highest quality of care.

Current Debates Critical to Future of Caregiving
Three current federal debates—repealing the Affordable Care Act (ACA), the future of Medicaid, and immigration reform—directly impact this low-income workforce, which is characterized by high numbers of immigrants and workers whose health coverage improved under the ACA. Roughly 500,000 direct care workers gained health coverage because of the Affordable Care Act.

“Around the country, but especially in rural America, we are witnessing severe workforce shortages in paid caregivers—a problem that will only worsen unless we improve the quality of these jobs with better wages, training, and career opportunities,” said Robert Espinoza, vice president of policy at PHI. Federal Policy Priorities: Strengthening the Direct Care Workforce is Issue 4 in PHI’s #60CaregiverIssues campaign.

Learn more at

Caring for the Future

Our new policy report takes an extensive look at today's direct care workforce—in five installments.

Workforce Data Center

From wages to employment statistics, find the latest data on the direct care workforce.